Eating disorders pose long-lasting physiological and psychological consequences, and
have one of the highest mortality rates amongst mental illnesses (Harris & Barraclough,
1998). In recent years, athletes have been frequently identified as at more risk of developing
eating disorders, and problematic eating attitudes and behaviours than the general population
(e.g., Sundgot-Borgen & Torstveit, 2004). Athletes with eating disorders not only risk
compromising their performance, but also their health and general wellbeing (Currie &
Morse, 2005). Therefore, the identification of the prevalence, as well as the potential factors
that is likely to contribute to eating disorders in athletes present a valuable avenue for
research.
The first study of this thesis examined the prevalence of potential eating disordered
cases amongst a sample of elite, developmental, and recreational British athletes, as well as a
control group of British non-athletes. Gender and sport type differences between and within
these aforementioned performance standards were also examined in this study. Results
demonstrated that while recreational athletes and non-athletes reported greater disturbed
eating psychopathology, there were no significant differences in the prevalence of probable
cases of eating disorder between elite, developmental, recreational, and non-athletes.
However, there was a trend for a higher number of non-athletes and recreational athletes
(males and females, regardless of sport type) to be classified as potential cases with clinical
eating disorders. In addition, a higher number of females from the elite and non-athlete
performance standards were classified as eating disordered than their respective male
counterparts. Thus, these findings provide evidence to suggest that eating disorders pose a
cause for concern in less competitive athletes and those that do not engage in organised sport
at all.
Guided by the established maintenance factors associated with eating disorders within
the general population (see Fairburn, Cooper, & Shafran, 2003), Studies 2 and 3 reflect a
series of cross-sectional investigations aimed to test the association between a range of
interpersonal difficulties and eating psychopathology. These studies were designed to fill the
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gap in the current eating disorder literature by examining multiple pathways between both
situational (i.e., relationship quality with parents, coaches, and teammates) and dispositional
interpersonal difficulties (i.e., attachment styles) and eating psychopathology via the
mediating variables of perfectionism, self-esteem and depression. Mediational analyses in
Study 2 revealed that relationship quality with parents and coaches as defined by social
support, interpersonal conflict, and insecure attachment styles were indirectly related to
athletes‟ eating psychopathology via the mediating roles self-critical perfectionism, selfesteem,
and depression. However, the quality of relationship with teammates was not
associated to athletes‟ eating psychopathology.
Study 3 further examined the association between eating psychopathology and
situational interpersonal difficulties (i.e., relationship quality with mother, father, and
coaches), as well as dispositional interpersonal difficulties (i.e., social anxiety and loneliness)
among a sample of athletes and non-athletes. Mediational analyses revealed that the quality
of the relationship with the father, and levels of loneliness were indirectly related to athletes‟
eating psychopathology via the mediating role of depression, while social anxiety was found
to be both directly and indirectly related (via depression) to athletes‟ eating psychopathology.
In the case of non-athletes, the quality of the relationship with both the mother and the father,
levels of social anxiety and loneliness were indirectly related to eating psychopathology via
the mediating role of depression, self-esteem, and self-critical perfectionism. Furthermore,
this study provided evidence to suggest that dispositional interpersonal difficulties may be
more robust independent predictors of athletes‟ and non-athletes‟ eating psychopathology
than situational interpersonal difficulties (i.e., relationship quality with significant others).
Collectively these studies suggest that the psychosocial mechanisms hypothesised to be
involved in eating disorders within the general population closely resemble that of athletes.
Employing a prospective research design, Study 4 examined the predictive role of
situational and dispositional interpersonal difficulties in athletes‟ eating psychopathology.
Conducted over a 6 month period, the findings of this study revealed that only situational
interpersonal difficulties as reflected in the quality of the relationship with coaches and
teammates were associated to athletes‟ eating psychopathology, over and above their initial
eating psychopathology. Moreover, the study highlighted interpersonal conflict within the
coach-athlete relationship as the only independent predictor of athletes‟ eating
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psychopathology. Therefore suggesting that conflict with the coach should be considered as
a potential risk factor in the development of eating disorders amongst athletes.
The final study tested the main constructs underlying the transdiagnostic cognitive
behavioural theory of eating disorders (Fairburn et al., 2003) within an athletic population.
Results revealed that elevated eating psychopathology may arise from an interaction of
“interpersonal difficulties”, low self-esteem, high levels of self-critical perfectionism, and
depressive symptoms. Moreover, findings of this study demonstrated that the tested model is
invariant across athletes‟ sport type and performance standard, but not across gender. Thus
suggesting that the psychosocial processes involved in eating disorders are the same
regardless of the type of sport, and the performance standard that an athlete competes in.
Overall, the findings of the current research revealed that while the prevalence of
eating disorders may be considerably lower within the British athletic population than the
general population, there is still cause for concern, given the high prevalence detected in
recreational athletes, as well as the high number of competitive athletes engaging in
inappropriate compensatory weight control behaviours (i.e., excessive exercise and selfinduced
vomiting). Moreover, the results of the latter studies suggest that psychosocial
factors are important and pertinent factors to consider in the aetiology of eating disorders
amongst athletes. As a whole, this thesis makes a significant contribution to furthering our
understanding of the prevalence and psychosocial correlates of eating psychopathology
amongst British athletes.

Description:

A Doctoral Thesis. Submitted in partial fulfillment of the requirements for the award of Doctor of Philosophy of Loughborough University.